Janssen RS, Holtgrave DR, Valdiserri RO, et al. The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
American Journal of Public Health (Impact Factor: 4.55). 08/2001; 91(7):1019-24. DOI: 10.2105/AJPH.91.7.1019
Source: PubMed
In the United States, HIV prevention programs have historically tailored activities for specific groups primarily on the basis of behavioral risk factors and demographic characteristics. Through the Serostatus Approach to Fighting the Epidemic (SAFE), the Centers for Disease Control and Prevention is now expanding prevention programs, especially for individuals with HIV, to reduce the risk of transmission as a supplement to current programs that primarily focus on reducing the risk of acquisition of the virus. For individuals with HIV, SAFE comprises action steps that focus on diagnosing all HIV-infected persons, linking them to appropriate high-quality care and prevention services, helping them adhere to treatment regimens, and supporting them in adopting and sustaining HIV risk reduction behavior. SAFE couple a traditional infectious disease control focus on the infected person with behavioral interventions that have been standard for HIV prevention programs.

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    • "First, MSM were defined as participants who self-identified as gay or bisexual, therefore straight-identifying MSM, a group arguably considered to be even more at-risk, were not included. Data from elsewhere suggest that MSM on the " down low " are even more stigmatized and may not engage in care, suggesting our findings to be conservative (Janssen et al., 2001; Joint United Nations Programme on HIV AIDS, Wolitski, Jones, Wasserman, & Smith, 2006). Black participants, in this dataset, were equally likely to self-identify as gay or bisexual relative to white participants, and more likely, relative to Hispanics. "
    [Show abstract] [Hide abstract] ABSTRACT: The US HIV/AIDS epidemic is concentrated among men who have sex with men (MSM). Black men are disproportionately affected by incarceration and Black MSM experience higher infection rates and worse HIV-related health outcomes compared to non-Black MSM. We compared HIV treatment outcomes for Black MSM to other HIV-infected men from one of the largest cohorts of HIV-infected jail detainees (N = 1270) transitioning to the community. Of the 574 HIV-infected men released, 113 (19.7%) self-identified as being MSM. Compared to other male subgroups, young Black MSM (<30 years old, N = 18) were significantly less likely: (1) before incarceration, to have insurance, access to an HIV healthcare provider, and use cocaine; (2) during incarceration, to receive a disease management intervention; and (3) in the 6 months post-release, to link to HIV care. Interventions that effectively link and retain young HIV-infected Black MSM in care in communities before incarceration and post-release from jail are urgently needed.
    Full-text · Article · Aug 2015 · AIDS Care
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    • "Duration of the clinical relationship may indicate a more recent diagnosis [53] and HIV-positive patients recently engaged in care report higher risk behaviours [11]. Other studies have indicated that it is important to capitalize on those newly infected patients [55] because diagnosis presents an opportunity to address prevention of transmission earlier in their illness. Offering continued messages to patients who have been living with HIV and engaged with services however is also necessary as these patients will continue to have distinct and changing needs over time [7, 56]. "
    [Show abstract] [Hide abstract] ABSTRACT: Positive health, dignity, and prevention (PHDP) interventions target people living with HIV and AIDS (PLHIV) to promote well-being and prevent onward transmission. Concern that increased life expectancy and improved well-being would lead to increased risky sexual behaviour and subsequent HIV transmission motivated researchers to test novel strategies to support treatment adherence, encourage safer sex, STI treatment and partner testing, prevention of mother to child transmission, and support uptake of family planning.
    Full-text · Article · Jul 2015 · PLoS ONE
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    • "Many attribute this disparity in HIV incidence to the high number of unrecognized HIV infections among Latino and Black MSM [3,7]. Detection of HIV infection is important for individuals because knowledge of infection status has great implications in sexual risk management, forward transmission, treatment linkage, and quality of life [8]. HIV-related stigma and homophobia are factors that reduce risk perception and willingness to test for HIV91011. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction Rates of unrecognized HIV infection are significantly higher among Latino and Black men who have sex with men (MSM). Policy makers have proposed that HIV self-testing kits and new methods for delivering self-testing could improve testing uptake among minority MSM. This study sought to conduct qualitative assessments with MSM of color to determine the acceptability of using electronic vending machines to dispense HIV self-testing kits. Materials and Methods African American and Latino MSM were recruited using a participant pool from an existing HIV prevention trial on Facebook. If participants expressed interest in using a vending machine to receive an HIV self-testing kit, they were emailed a 4-digit personal identification number (PIN) code to retrieve the test from the machine. We followed up with those who had tested to assess their willingness to participate in an interview about their experience. Results Twelve kits were dispensed and 8 interviews were conducted. In general, participants expressed that the vending machine was an acceptable HIV test delivery method due to its novelty and convenience. Discussion Acceptability of this delivery model for HIV testing kits was closely associated with three main factors: credibility, confidentiality, and convenience. Future research is needed to address issues, such as user-induced errors and costs, before scaling up the dispensing method.
    Full-text · Article · Jul 2014 · PLoS ONE
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